Urinary tract infections (UTIs) are very common in women. It’s probably because evolution is playing a cruel trick on them by placing all of the body’s dirty bits within bacteria’s commuting distance. UTIs can be caused by having sex and wearing luminous g-strings but, despite what your mum told you, not necessarily by wiping back to front.

Unfortunately, 25 – 30% of women who show up at the GP with UTI symptoms, are not given any treatment because their test for UTI has come back negative. Research from Belgium (the place with beer, chocolate, waffles and french fries with mayonnaise) used a fancy test that showed almost all of the women with urinary complaints, but negative test results, actually have a bacterial infection. They report their urine adventure in the journal Clinical Microbiology and Infection.

Once diagnosed, UTIs are fairly easy to treat. By scoffing the appropriate antibiotics and throwing the g-strings into the Salvo’s collection bin, you can kiss goodbye to the urge to wee all the time. In the past, women who had the symptoms of UTI but negative UTI test results were often diagnosed with “urethral syndrome” and some doctors said was psychosomatic. Really.

The flemish scientists took the mid-stream urine (the bit between the sigh of relief and wishing it would hurry up) and tested it for the presence of Escherichia coli and Staphylococcus saprophyticus. They tested the mid-stream urine of 220 women with symptoms and 86 women that didn’t have any symptoms and compared the outcomes.

Once the pee had been carefully directed towards, into and all over a sample container, it was tested for the presence of bacteria. Alongside the standard tests for UTIs, the researchers also used a technique called quantitative polymerase chain reaction, or qPCR. Apart from sounding like a home shopping channel, qPCR looks for the DNA that comes from the UTI bacteria and is way more sensitive than the standard tests.

Among the women with UTI symptoms, standard testing detected bacteria in 80.9% of urine samples. But the qPCR test found that 95.9% of samples contained Escherichia coli and 8.6% had Staphylococcus saprophyticus. Combining the results of both tests, the researchers found infections in 98.2% of women with symptoms.

In other words, if you be burning on urination you better start taking that medication.

In the women without symptoms, standard testing picked up Escherichia coli in 10.5% of samples and qPCR picked up E. coli in 11.6%. They did this bit to show that the findings in the symptomatic group were not caused by the detection of contamination due to the higher sensitivity of qPCR.

The clinical recommendations from the study are simple: if non-pregnant women consult their GP about UTI symptoms the diagnosis of a UTI can be accepted without further investigations and can be treated. Instead of spending time and energy to prove an uncomplicated UTI, doctors can rely on a diagnosis based on the typical symptoms and focus on acknowledging and managing the patient’s complaints – such as how long they had to wait in the waiting room.

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